Dr Andrea Britton, Syeda Islam, and Dr Alison Hoger
The COVID-19 pandemic and the United States’ funding cuts to programs has affected rabies control efforts in the Americas, and meant the disease has reemerged in dogs in some countries for the first time in 25 years. These findings were among the updates shared at the Rabies in the Americas (RITA) conference in Lima, Peru in September. One Health SIG Co-convenor, Dr Andrea Britton, presented on the “Rabies in Borneo” conference platform and PHAA member, Dr Alison Hoger, explained the lyssavirus situation in Australia. The Rabies in Borneo conference has occurred annually since 2022 associated with World Rabies Day in September bringing together public health professionals, animal and human health sectors, researchers, government, health sectors, global experts, wildlife veterinarians, communication units and Immune Belt Enforcement Team to share implementation successes and local knowledge.
With resources being redirected, the COVID pandemic has led to significant setbacks in rabies control and elimination programs and the subsequent increase in incidence and spread. Genomic sequencing of rabies viruses supports control programs by identifying transmission pathways both within countries and across borders. More broadly across the region, canine rabies has re-emerged in the south Americas with spread from Bolivia into Peru (with an outbreak in Arequipa) after 25 years. Vampire bat (Desmodus rotundus) rabies is the predominant reservoir in South America, with some particularly vulnerable communities in the Amazon region receiving pre-exposure prophylaxis (two doses of rabies vaccine).
A One Health approach to rabies control is necessary for integrated surveillance, and sharing of information, and coordination across sectors. The United Against Rabies forum was established in 2020 by the tripartite (World Health Organization, World Organization for Animal Health, and Food and Agricultural Organization) to support implementation of the “Zero by 30” global strategic mission. This involves an inclusive network of stakeholders that support countries to implement sustainable rabies control. Several resources are available on their website, including the development of national plans and minimum data elements.
The Association of South East Asian Nations (ASEAN) region has a regional ASEAN Rabies Elimination Strategy that was recently updated. The GAVI investment of PEP (post-exposure prophylaxis treatment) is being implemented by partners like UNICEF in five countries. Mexico has validated elimination of dog-mediated human rabies, proving that with sustained national commitment it is possible to eliminate dog-mediated human rabies. However, shifting global health priorities and funding challenges are hindering many countries from eliminating rabies.
In remote areas of Peru (Achuar village, Loreto), outbreaks have occurred where there are no medical facilities or cold-chain capacity for vaccines, and the drop in funding from the USA is greatly affecting control programs. Communities suspected witchcraft or ancestral punishment as the cause of deaths.
In her update on the Rabies in Borneo conference, Dr Britton explained that oral rabies vaccination (ORV) trials in dogs are occurring in Namibia, Indonesia, Cambodia, Thailand, the Philippines, and are also pending in Sarawak, Malaysia. ORV has been used for several decades to control rabies in wildlife. The use of ORV in dogs is to increase population-level immunity, with parental vaccination being the main vaccination strategy. Some free-roaming dogs are difficult to catch, so in these groups of dogs ORV are being administered.
PHAA member Dr Alison Hoger from the University of Queensland featured a poster on pediatric rabies and presented her doctoral research on Australian bat lyssavirus (ABLV). There are currently 18 known Lyssavirus genus (16 are reported in Rupprecht et al. 2025) globally, all of which have the potential to cause rabies encephalitis disease. Two distinct variants of ABLV circulate in Australia; one among Pteropus (flying foxes) and the other in Saccolaimus flaviventris (microbat), although all bats in Australia have the potential to carry ABLV.
To date, there have been four ABLV human deaths, including one in NSW this year. Two horses have also died, demonstrating the potential risk of spillover into terrestrial mammals. Increased public health awareness regarding risks and post-exposure actions to take if bitten or scratched by bats is important, given that infections are almost always fatal once symptoms develop.
The increasing overlap between bats, humans, and terrestrial mammals affirms the need for expanded public health awareness campaigns, and strengthened prevention strategies.
Overall, the experiences and evidence shared throughout the Peru conference reinforce that progress against rabies is achievable when human, animal, and environmental health sectors work together. The Australian PHAA representation at RITA 2025 highlighted our role in assisting our neighbours in the Asia-Pacific region with rabies control, and the unique disease ecology of Australia’s only endemic lyssavirus. While resource constraints and emerging epidemiological patterns continue to challenge control efforts, innovations in surveillance, vaccination strategies, and regional cooperation offer important pathways forward. Continued leadership and partnership will be crucial as countries strive toward “Zero by 30” and work to protect communities from preventable rabies and lyssavirus infections.
Dr Andrea Britton, Syeda Islam, and Dr Alison Hoger are all members of the Public Health Association of Australia’s One Health Special Interest Group
Image of a vampire bat by Daniel Streicker, US CDC.
Leave a Reply